Chinese Journal of Tissue Engineering Research ›› 2015, Vol. 19 ›› Issue (26): 4123-4126.doi: 10.3969/j.issn.2095-4344.2015.26.005

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One-stage artificial joint replacement for unstable intertrochanteric fracture in aged patients: 6-month follow-up of hip joint function 

Cui Zhi-yong1, Wang Xue1, Guo Peng-chao1, Wang Cheng-wei2   

  1. 1Second Department of Orthopedics, Changji Prefecture People’s Hospital, Changji Prefecture 831100, Xinjiang Uygur Autonomous Region, China; 2Department of Orthopedics, the Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
  • Received:2015-05-01 Online:2015-06-25 Published:2015-06-25
  • About author:Cui Zhi-yong, Second Department of Orthopedics, Changji Prefecture People’s Hospital, Changji Prefecture 831100, Xinjiang Uygur Autonomous Region, China

Abstract:

BACKGROUND: Conventional dynamic hip screw or artificial joint replacement can be used to treat unstable intertrochanteric fracture in aged patients. It remains unclear whether we should select one-stage replacement or remedial joint replacement after failture, and there is no unified standard globally.
OBJECTIVE: To observe the outcomes and prognosis of one-stage artificial joint replacement for unstable intertrochanteric fracture in aged patients.
METHODS: From April 2008 to October 2011, 21 patients with unstable intertrochanteric fracture in aged patients were repaired with one-stage artificial joint replacement at the Second Department of Orthopedics, Changji Prefecture People’s Hospital. Among 21 patients, 1 patient previously combined with avascular necrosis of the 
femoral head and traumatic arthritis received biological artificial total hip replacement. Three cases were subjected to standard bone cement bipolar artificial femoral head replacement. 17 cases underwent biological bipolar artificial femoral head prosthesis replacement. All artificial joint, internal fixation material and accessory joint replacement surgical instruments were purchased outside China. All patients were followed up regularly. Hip joint function was assessed by Harris hip score.
RESULTS AND CONCLUSION: All operations were completed by the same group of physicians. Operation time was 30-60 minutes, averagely 42 minutes. Incision length was 8 to 15 cm, averagely 11 cm. Average intraoperative blood loss was 50-300 mL, averagely 150 mL. The number of transfusion cases was 13. 1.5 U blood was transfused averagely in each patient during hospital stay. One 76-year-old patient combined with hypertension, coronary heart disease and diabetes suffered from sudden death due to acute myocardial infarction at 9 days after replacement. B ultrasound revealed venous thrombosis of calf muscle of double lower extremities at 3 days after replacement. No complications such as prosthetic loosening, sinking, infections and thrombosis were detected. Except 1 case died, the other 20 cases received follow-up for 6-49 months. Harris hip score was 73±4 before discharge and 82±6 during last follow-up. These data confirm that effects of one-stage artificial joint replacement for unstable intertrochanteric fracture in aged patients are affirmative, but the number of case is still less, and deserves further investigations. We suggest that in patients with conformed indication, one-stage artificial joint replacement can be the first choice.
 

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程

Key words: 植入物, 人工假体, 人工关节置换, 关节植入物, 老年, 不稳定型, 股骨转子间骨折, 髋关节Harris评分, 随访研究, 并发症

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